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Alwadany MM, Alotaibi MA, Almousa AS, Alawdah AM, AlDera NM, Alqahtan GM, Al Ajeel HY. The Prevalence and Clinical Features of Skin Irritation Caused by Infection Prevention Measures During COVID-19 in Riyadh Region, Saudi Arabia. Cureus 2023; 15:e39846. [PMID: 37397648 PMCID: PMC10314809 DOI: 10.7759/cureus.39846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2023] [Indexed: 07/04/2023] Open
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), caused by a novel coronavirus (CoV), was reported at the end of 2019 and caused a severe public health concern. It caused high mortalities by respiratory failure among infected people and was declared a pandemic by the World Health Organization (WHO) in March 2020. This virus caused infections through air or direct contact which documented a huge number of fatalities. AIM This study aims to examine the impact of the COVID-19 pandemic on skin eczema of the general public in the Riyadh region of Saudi Arabia. METHODS This is a descriptive, cross-sectional, survey-based study, that was conducted via an online survey distributed to the general population of Riyadh for the period between January and February 2023. Data was collected through a questionnaire which was distributed through the social media websites. RESULTS A total of 697 participants were involved in this study. Around one-fifth of the study participants (19.5%) reported that they suffer from some form of allergy and have family history of allergy (21.8%). Eczema was the most common type of allergy among the study participants accounting for 32.4%. A total of 116 participants (16.6%) reported that they have personal history of hand eczema or other skin disease on the hands. Cleaning and sterilization materials were reported as the most common cause of dryness and irritation of eczema (62.1%). Around 41.0% of the participants reported that they noticed a worsening of their symptoms after the pandemic, of which dryness was the most commonly reported sign noticed getting worse by 68.1% of the participants. The vast majority of the participants (89.7%) reported that new skin symptoms emerged on their hands after the beginning of the pandemic, of which dryness was reported by all the participants. CONCLUSION A considerable proportion of participants, particularly those with a history of hand eczema, experienced dermatological difficulties, including skin damage, due to the usage of COVID-19 preventive strategies. Thus, we recommend increasing the use of innovative infection prevention approaches and skin protection measures, such as regular hand hydration and maybe the use of less toxic skin disinfectants.
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Affiliation(s)
| | - Manar A Alotaibi
- Department of Dermatology, Prince Sultan Military Medical City, Riyadh, SAU
| | | | | | - Norah M AlDera
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
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Haft MA, Park HH, Lee SS, Sprague JM, Paller AS, Cotton CH, Thyssen JP, Eichenfield LF. Diagnosis and Management of Pediatric Chronic Hand Eczema: The PeDRA CACHES Survey. Paediatr Drugs 2023:10.1007/s40272-023-00574-x. [PMID: 37225932 DOI: 10.1007/s40272-023-00574-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Chronic hand eczema (CHE) significantly impacts quality of life. Published literature on pediatric CHE (P-CHE) in North America including knowledge on epidemiology and standard evaluation and management is limited. OBJECTIVE Our objective was to assess diagnostic practices when evaluating patients with P-CHE in the US and Canada, produce data on therapeutic agent prescribing practices for the disorder, and lay the foundation for future studies. METHODS We surveyed pediatric dermatologists to collect data on clinician and patient population demographics, diagnostic methods, therapeutic agent selection, among other statistics. From June 2021 to January 2022, a survey was distributed to members of the Pediatric Dermatology Research Alliance (PeDRA). RESULTS Fifty PeDRA members responded stating that they would be interested in participating, and 21 surveys were completed. For patients with P-CHE, providers most often utilize the diagnoses of irritant contact dermatitis, allergic contact dermatitis, dyshidrotic hand eczema, and atopic dermatitis. Contact allergy patch testing and bacterial hand culture are the most used tests for workup. Nearly all utilize topical corticosteroids as first line therapy. Most responders report that they have treated fewer than six patients with systemic agents and prefer dupilumab as first-line systemic therapy. CONCLUSIONS This is the first characterization of P-CHE among pediatric dermatologists in the United States and Canada. This assessment may prove useful in designing further investigations including prospective studies of P-CHE epidemiology, morphology, nomenclature, and management.
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Affiliation(s)
- Michael A Haft
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital San Diego, 3020 Children's Way, Mail Code 5092, San Diego, CA, 92130, USA
- Department of Dermatology and Pediatrics, University of California San Diego School of Medicine, 9500 Gilman Drive, MC 0869, La Jolla, CA, 92093-0869, USA
| | - Helen H Park
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital San Diego, 3020 Children's Way, Mail Code 5092, San Diego, CA, 92130, USA
- Department of Dermatology and Pediatrics, University of California San Diego School of Medicine, 9500 Gilman Drive, MC 0869, La Jolla, CA, 92093-0869, USA
| | - Stephanie S Lee
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital San Diego, 3020 Children's Way, Mail Code 5092, San Diego, CA, 92130, USA
- Department of Dermatology and Pediatrics, University of California San Diego School of Medicine, 9500 Gilman Drive, MC 0869, La Jolla, CA, 92093-0869, USA
| | - Jessica M Sprague
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital San Diego, 3020 Children's Way, Mail Code 5092, San Diego, CA, 92130, USA
- Department of Dermatology and Pediatrics, University of California San Diego School of Medicine, 9500 Gilman Drive, MC 0869, La Jolla, CA, 92093-0869, USA
| | - Amy S Paller
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N. St. Clair St. Suite 1600, Chicago, IL, 60611, USA
| | - Colleen H Cotton
- Division of Dermatology, Children's National Hospital, 111 Michigan Avenue, NW, Washington, D.C, 20010, USA
- Department of Dermatology, George Washington School of Medicine and Health Sciences, 2150 Pennsylvania Ave, NW, Suite 2B-430, Washington, DC, 20037, USA
| | - Jacob P Thyssen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, DK 2400, Copenhagen, NV, Denmark
| | - Lawrence F Eichenfield
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital San Diego, 3020 Children's Way, Mail Code 5092, San Diego, CA, 92130, USA.
- Department of Dermatology and Pediatrics, University of California San Diego School of Medicine, 9500 Gilman Drive, MC 0869, La Jolla, CA, 92093-0869, USA.
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Piapan L, Di Taranto D, Patriarca E, Rui F, Larese Filon F. Hand Eczema in Apprentice Nurses during the COVID-19 Pandemic after a Skin Prevention Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2992. [PMID: 36833687 PMCID: PMC9964949 DOI: 10.3390/ijerph20042992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Healthcare workers, particularly nurses and apprentice nurses, are at high risk of the development of hand eczema due to daily exposure to wet work. This study aimed to assess the occurrence of hand eczema in a group of first-, second-, and third-year apprentice nurses at the University Hospitals of Trieste (northeastern Italy) during the COVID-19 pandemic. METHODS Two hundred forty-two Nursing School students were recruited. Data were collected using a standardized questionnaire based on the Nordic Occupational Skin Questionnaire, and all patients underwent a medical examination to evaluate their skin condition based on standard scores. Transepidermal water loss was also measured. The factors associated with hand eczema were investigated using univariate and multivariate logistic regression analyses. RESULTS The prevalence of hand eczema was low in students both before and after the traineeship (17.9 and 21.5%, respectively), but clinical signs of mild skin damage, mainly skin dryness, were present in 52.3 and 47.2%, respectively. The factor associated with hand eczema was a personal history of atopic eczema (odd ratios 2.61, 95% confidence intervals 1.18-5.80), while exposure to irritants and glove use did not reach statistical significance. CONCLUSIONS Our findings might be explained by the preventive measures adopted for skin protection among healthcare workers in Trieste since the apprenticeship.
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Affiliation(s)
| | | | | | | | - Francesca Larese Filon
- Unità Clinico Operativa di Medicina del Lavoro, Università di Trieste, Via della Pietà 2/2, 342129 Trieste, Italy
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Cheng J, Facheris P, Ungar B, Guttman-Yassky E. Current emerging and investigational drugs for the treatment of chronic hand eczema. Expert Opin Investig Drugs 2022; 31:843-853. [PMID: 35658708 DOI: 10.1080/13543784.2022.2087059] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION : Chronic hand eczema (CHE) is a highly prevalent, burdensome condition associated with functional impairment. Currently, topical therapeutics are the mainstay of CHE management. However, many cases are refractory to existing topical therapeutics, and the few existing systemic options are often limited in efficacy and by their side effect profiles. AREAS COVERED : Following a brief overview of CHE pathogenesis and existing treatments, this review will outline the mechanisms and available data on emerging and investigational drugs currently being studied in clinical trials for the treatment of CHE. EXPERT OPINION : Immunomodulatory drugs such as topical and systemic JAK inhibitors and Th2-targeting antibodies such as dupilumab are currently under investigation for CHE treatment, with early promise. Management of CHE will likely move toward more targeted treatments through clinical trials and away from broad immunosuppressants such as cyclosporine and methotrexate, which have previously been investigated for CHE and have more side effects. In coming years, CHE patients may benefit from a wider range of both topical and systemic therapeutics that target immune pathways relevant to the various CHE subtypes.
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Affiliation(s)
- Julia Cheng
- Department of Dermatology, Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paola Facheris
- Department of Dermatology, Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Benjamin Ungar
- Department of Dermatology, Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emma Guttman-Yassky
- Department of Dermatology, Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Loman L, Brands MJ, Massella Patsea AA, Politiek K, Arents BW, Schuttelaar ML. Lifestyle factors and hand eczema: a systematic review and meta‐analysis of observational studies. Contact Dermatitis 2022; 87:211-232. [PMID: 35277987 PMCID: PMC9541324 DOI: 10.1111/cod.14102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/08/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
Abstract
Evidence regarding the association between lifestyle factors and hand eczema is limited.To extensively investigate the association between lifestyle factors (smoking, alcohol consumption, stress, physical activity, body mass index, diet, and sleep) and the prevalence, incidence, subtype, severity, and prognosis of hand eczema, a systematic review and meta‐analysis were conducted in accordance with the Meta‐analysis Of Observational Studies in Epidemiology consensus statement. MEDLINE, Embase, and Web of Science were searched up to October 2021. The (modified) Newcastle‐Ottawa Scale was used to judge risk of bias. Quality of the evidence was rated using the Grades of Recommendation, Assessment, Development and Evaluation approach. Eligibility and quality were blindly assessed by two independent investigators; disagreements were resolved by a third investigator. Data were pooled using a random‐effects model, and when insufficient for a meta‐analysis, evidence was narratively summarized. Fifty‐five studies were included. The meta‐analysis (17 studies) found very low quality evidence that smoking is associated with a higher prevalence of hand eczema (odds ratio 1.18, 95% confidence interval 1.09‐1.26). No convincing evidence of associations for the other lifestyle factors with hand eczema were found, mostly due to heterogeneity, conflicting results, and/or the limited number of studies per outcome.
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Affiliation(s)
- Laura Loman
- Department of Dermatology University of Groningen, University Medical Center Groningen Groningen the Netherlands
| | - Marjolein J. Brands
- Department of Dermatology University of Groningen, University Medical Center Groningen Groningen the Netherlands
| | - Anna A.L. Massella Patsea
- Department of Dermatology University of Groningen, University Medical Center Groningen Groningen the Netherlands
| | - Klaziena Politiek
- Department of Dermatology Medical Center Leeuwarden Leeuwarden the Netherlands
| | - Bernd W.M. Arents
- Dutch Association of People with Atopic Dermatitis Nijkerk the Netherlands
| | - Marie L.A. Schuttelaar
- Department of Dermatology University of Groningen, University Medical Center Groningen Groningen the Netherlands
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Imran S, Khalid M, Husain N, Khan MQ, Shaikh S. The efficacy of topical Marham-e-Akbar in chronic atopic dermatitis - an open-label interventional study. Drug Metab Pers Ther 2022; 37:289-294. [PMID: 35218174 DOI: 10.1515/dmpt-2021-0195] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/12/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Chronic atopic dermatitis (AD) is an inflammatory skin condition marked by intense pruritus, dry skin, and severe impact on the life quality of the patients. Conventionally, it is managed by using emollients, calcineurin inhibitors, and topical corticosteroids. In Unani medicine, eminent scholars advocated many drug formulations including topical Marham-e-Akbar for effective healing of AD but scientific evidence is scarce. Hence, this study was designed. METHODS This was a single-arm clinical trial conducted on 30 participants aged 18-65 years suffering from chronic AD after obtaining written informed consent. The trial intervention was Marham-e-Akbar consisting of Murdār Sang (Plumbi oxidum); Sindūr (red lead); olive oil (Olea europaea oil); Kath (Acacia catechu extract); Safeda Kāshgari (Zinc oxide); Sirka (vinegar); and Phitkirī (alum) to be applied twice daily for 42 days. The objective parameters were SCORAD and DLQI, while the subjective parameters included itching, scaling, and erythema assessed on a customized VAS scale and 4-point Likert scale. RESULTS The pre-post analysis inferred statistically significant attenuation in subjective parameters (itching, scaling, and erythema) and objective scales (SCORAD) and (DLQI) with p<0.001. CONCLUSIONS The study findings deduced that Marham-e-Akbar is effective in the amelioration of chronic atopic dermatitis and quality of life of the patients as well.
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Affiliation(s)
- Shaikh Imran
- Department of Medicine (Unani), Luqman Unani Medical College Hospital and Research Center, Bijapur, Karnataka, India
| | - Mohd Khalid
- Department of Medicine (Unani), Luqman Unani Medical College Hospital and Research Center, Bijapur, Karnataka, India
| | - Nazim Husain
- Department of Medicine (Unani), Luqman Unani Medical College Hospital and Research Center, Bijapur, Karnataka, India
| | - Mohd Qudrathullah Khan
- Department of Medicine (Unani), Luqman Unani Medical College Hospital and Research Center, Bijapur, Karnataka, India
| | - Shalina Shaikh
- Department of Medicine (Unani), Luqman Unani Medical College Hospital and Research Center, Bijapur, Karnataka, India
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Voorberg AN, Loman L, Schuttelaar MLA. Prevalence and Severity of Hand Eczema in the Dutch General Population: A Cross-sectional, Questionnaire Study within the Lifelines Cohort Study. Acta Derm Venereol 2022; 102:adv00626. [PMID: 34664079 PMCID: PMC9631254 DOI: 10.2340/actadv.v101.432] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 11/16/2022] Open
Abstract
Data on chronic hand eczema and severity of hand eczema in the general population is scarce. In this cross-sectional study, a questionnaire was sent to 135,950 Lifelines Cohort Study participants, in order to investigate the prevalence and severity of hand eczema in the Dutch general population. In total, 57,798 subjects were included. The lifetime prevalence of hand eczema was 15.0% (95% confidence interval 14.7-15.3), the 1-year prevalence 7.3% (95% confidence interval 7.1-7.6), and the self-reported physician-diagnosed prevalence 6.1% (95% confidence interval 5.9-6.3). The 1-year prevalence of chronic hand eczema was 4.7% (95% confidence interval 4.5-4.9). The majority (56.9%) of the subjects with hand eczema had almost clear at worst ever and the prevalence of severe to very severe hand eczema at worst ever in the general population was 1.9% (95% confidence interval 1.8-2.1). Future epidemiological studies in the general population should include data about chronic hand eczema and severity of hand eczema, as this can provide perspective on the burden of hand eczema.
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Affiliation(s)
| | | | - Marie L A Schuttelaar
- Department of Dermatology, University of Groningen, University Medical Center Groningen, PO Box 30 001 NL-9700 RB Groningen, The Netherlands.
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Wang J, Tischer C, Standl M, Weidinger S, von Berg A, Herberth G, Yew YW, Heinrich J, Schmitt J, Apfelbacher C. Lifetime prevalence and determinants of hand eczema in an adolescent population in Germany: 15-year follow-up of the LISA cohort study. J Eur Acad Dermatol Venereol 2021; 36:547-556. [PMID: 34779040 DOI: 10.1111/jdv.17814] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/22/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Hand eczema is a common inflammatory skin disorder in both adolescence and adulthood. OBJECTIVES We sought to assess the lifetime prevalence of hand eczema and associated exogenous and endogenous risk factors among adolescents in Germany. METHODS This was a cross-sectional study embedded into a prospective population-based birth cohort in four regions of Germany, which recruited healthy neonates born between November 1997 and January 1999. We included 1736 participants who had completed the 15-year follow-up from birth cohort and 84.6% (1468/1736) had clearly reported whether they have ever had hand eczema. All the data were based on questionnaires and blood tests (immunoglobulin E). Multivariable logistic regression analysis was used to examine endogenous and exogenous factors in relation to the lifetime prevalence of hand eczema among adolescents. RESULTS One thousand four hundred and sixty-eight adolescents (715 girls, 48.7%) were included in the final analysis. The lifetime prevalence of hand eczema among adolescents at the age of 15 was 10.4% (95% confidence interval [CI]: 8.9%-12.1%), with a significantly higher lifetime prevalence among girls than boys (12.7% vs. 8.2%, P = 0.005). Multivariable logistic regression analysis indicated statistically significant associations between the lifetime prevalence of hand eczema and having ever been diagnosed with atopic dermatitis (aOR = 1.8, 95% CI: 1.1-2.8) or having ever had dry skin (aOR = 1.9, 95% CI: 1.1-3.1), respectively. No statistically significant independent associations were found between asthma, hay fever, allergy-related clinical symptoms, immunoglobulin E positivity and other exogenous factors in relation to hand eczema. CONCLUSION Our study fills a research gap on the epidemiological burden of hand eczema among adolescents. One out of ten ever suffered from hand eczema until age 15 years indicating that hand eczema constitutes a significant burden in paediatric populations. The role of atopic dermatitis in hand eczema reinforces previous findings. Exogenous risk factors warrant further investigation.
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Affiliation(s)
- J Wang
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University, Magdeburg, Germany
| | - C Tischer
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University, Magdeburg, Germany.,Institute for Evidence-Based Health Resort Medicine and Health Promotion, State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany.,Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany
| | - M Standl
- Institute of Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
| | - S Weidinger
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Kiel, Germany
| | - A von Berg
- Department of Pediatrics, Research Institute, Marien-Hospital Wesel, Wesel, Germany
| | - G Herberth
- Department of Environmental Immunology/Core Facility Studies, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
| | - Y W Yew
- National Skin Centre, Singapore City, Singapore
| | - J Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany.,Comprehensive Pneumology Center Munich, German Center for Lung Research, Munich, Germany.,Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - J Schmitt
- Center for Evidence-Based Healthcare, Faculty of Medicine Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - C Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University, Magdeburg, Germany
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Analysis and Quantification of Alkyl (C12-22) Trimethyl Ammonium Chloride Content in Cosmetics: Regulatory Compliance Gap Analysis. COSMETICS 2021. [DOI: 10.3390/cosmetics8040103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: Exceeding the recommended Alkyl (C12-22) trimethyl ammonium bromide and chloride levels in cosmetics and personal care products is a serious health threat. Objectives: To quantify and investigate Cetrimonium chloride and Behentrimonium chloride in cosmetics and personal care products in the UAE market to gauge whether or not they adhered to requirements for safety and health. Methods: A total of 164 cosmetics products were collected and analyzed in this study. The gas chromatography–mass spectrometry (GC–MS) method was developed and validated for the determination of Cetrimonium chloride and Behentrimonium chloride surfactants in cosmetics products. With each product, Cetrimonium chloride and Behentrimonium chloride (%) were calculated. To test cross-group differences in Cetrimonium chloride and Behentrimonium chloride (%), Kruskal–Wallis test was applied. Results: Of the 125 tested cosmetics and personal care products, five (4%) exceeded the recommended Cetrimonium chloride level in rinse-off hair products (2.5%), 10 (8%) exceeded the recommended Cetrimonium chloride level in leave-on hair products (1%), and 24 (61.5%) exceeded the recommended Cetrimonium chloride level used as a preservative in cosmetics products. Moreover, of the 125 tested cosmetics and personal care products, 21 (53.8%) exceeded the recommended Behentrimonium chloride level used as preservatives in cosmetics products. Conclusions: Although several structures for cosmetics quality and control across the globe are fairly comprehensive and intricate, there is a need to make them more rigorous to apply compliance with GMP and ensure regulatory control. Doing so would help enhance the inspection and regulation of cosmetics containing Behentrimonium chloride/Cetrimonium chloride preservatives. Furthermore, there is a dire need to establish a unified cosmetovigilance worldwide.
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Yüksel YT, Ebbehøj NE, Agner T. An update on the prevalence and risk exposures associated with hand eczema in Danish hospital employees: A cross-sectional questionnaire-based study. Contact Dermatitis 2021; 86:89-97. [PMID: 34655082 DOI: 10.1111/cod.13990] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/09/2021] [Accepted: 10/11/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hand eczema (HE) is common in health care workers (HCWs). During the last decade, new recommendations have supported increased use of alcohol-based hand rub (ABHR) to partially replace hand washings to lower the prevalence of HE. However, newer data on this recommendation is lacking. OBJECTIVES To assess current 1-year prevalence of HE in HCWs, to investigate exposure, and the extent of subjective discomfort to hand washings and ABHR. METHODS A digital questionnaire was sent to 4876 HCWs from April to May 2020. RESULTS Of 2125 respondents (1779 women, 346 men), 14.7% reported HE within the last year. In total, 9.1% reported >20 hand washings per shift and 76.0% reported ABHR use >20 times per shift. HE was significantly associated with hand washings (adjusted odds ratio [OR] 1.73 [95% confidence interval [CI] 1.26-2.36]) and glove use on wet skin (adjusted OR 1.99 [95% CI 1.27-3.12]). Subjective discomfort to ABHR was reported significantly more often than to hand washings (P < .001) and significantly more often in HCWs with HE than in those without HE (P < .001). CONCLUSIONS The current 1-year HE prevalence in HCWs of 14.7% was lower than in previously reported Scandinavian data. HE was related to frequent hand washings, as previously reported, and to glove use on wet skin, which is a possible risk factor for HE that should be further explored.
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Affiliation(s)
- Yasemin T Yüksel
- Department of Dermatology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Niels E Ebbehøj
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Tove Agner
- Department of Dermatology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
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ZahrAllayali A, Al-Doboke A, Alosaimy R, Alabbasi R, Alharbi S, Fageeh S, Altayyar S, Azher R. The Prevalence and Clinical Features of Skin Irritation Caused by Infection Prevention Measures During COVID-19 in the Mecca Region, Saudi Arabia. Clin Cosmet Investig Dermatol 2021; 14:889-899. [PMID: 34285535 PMCID: PMC8286085 DOI: 10.2147/ccid.s309681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/12/2021] [Indexed: 01/09/2023]
Abstract
PURPOSE Due to the COVID-19 pandemic, recommendations to prevent infection suggest increasing the frequency of handwashing and disinfection; however, these measures can have negative implications on our skin. This study aims to evaluate whether these measures correlate with new-onset skin damage or can exacerbate hand eczema among the general population. MATERIALS AND METHODS This was a descriptive, cross-sectional, survey-based study, including the general population of Mecca region, Saudi Arabia. To achieve the study's aim, an online questionnaire to the general population comprising 25 items was distributed via social media apps during the pandemic between October 23 and November 21, 2020. Data were automatically collected in Excel and entered into SPSS for analysis. RESULTS A total of 783 participants were included in this study, of whom 695 (88.8%) were female. A history of hand eczema was reported among 123 (15.7%) participants, and 270 (34.5%) had a history of atopy. During the COVID-19 pandemic, 86 (13.0%) participants noticed new-onset skin irritation, while 81 (31.3%) of the participants reported exacerbation of earlier hand allergic dermatitis. The most frequent symptoms were dryness and feeling of tightness. Additionally, most participants among both groups noticed that skin lesions appeared for less than 10 days. The frequent handwashing statistically increased following the onset of the pandemic (p=0.001), there is association between new-onset symptoms and more frequent handwashing, as well as the use of hand disinfectants, during the pandemic (p=0.001). CONCLUSION Our study suggests that the general population's skin was negatively affected by COVID-19 precautions, particularly those with a history of hand eczema. We recommend spreading awareness of skin protective modalities and the use of new infection prevention measures, such as regular skin moisturization for hand protection and possibly using less damaging skin disinfectants like ozonized water provided it is scientifically proven effective in disinfecting COVID-19 virus.
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Affiliation(s)
- Ahmed ZahrAllayali
- Dermatology, Department of Internal Medicine, College of Medicine, Umm Al-Qura University, Al-Abdia Main Campus, Makkah, Saudi Arabia
| | - Amal Al-Doboke
- College of Medicine, Umm Al-Qura University, Al-Abdia Main Campus, Makkah, Saudi Arabia
| | - Rawan Alosaimy
- College of Medicine, Umm Al-Qura University, Al-Abdia Main Campus, Makkah, Saudi Arabia
| | - Renan Alabbasi
- College of Medicine, Umm Al-Qura University, Al-Abdia Main Campus, Makkah, Saudi Arabia
| | - Sara Alharbi
- College of Medicine, Umm Al-Qura University, Al-Abdia Main Campus, Makkah, Saudi Arabia
| | - Sarah Fageeh
- College of Medicine, Umm Al-Qura University, Al-Abdia Main Campus, Makkah, Saudi Arabia
| | - Shahad Altayyar
- College of Medicine, Umm Al-Qura University, Al-Abdia Main Campus, Makkah, Saudi Arabia
| | - Ruqayya Azher
- Department of Community Medicine, College of Medicine, Umm Al-Qura University, Al-Abdia Main Campus, Makkah, Saudi Arabia
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12
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Girolomoni G, de Bruin-Weller M, Aoki V, Kabashima K, Deleuran M, Puig L, Bansal A, Rossi AB. Nomenclature and clinical phenotypes of atopic dermatitis. Ther Adv Chronic Dis 2021; 12:20406223211002979. [PMID: 33854747 PMCID: PMC8010850 DOI: 10.1177/20406223211002979] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 02/25/2021] [Indexed: 12/14/2022] Open
Abstract
Atopic dermatitis is a heterogeneous disease and resists classification. In this review, we discuss atopic dermatitis nomenclature and identify morphologic phenotypes, which will facilitate correct diagnoses and development of treatment strategies. We support using the term 'atopic dermatitis' rather than eczema, because it describes the allergic background and inflammation ('itis') as drivers of the disease. Atopic dermatitis has many morphologic manifestations that vary by topographic area affected, age, or race and require consideration in differential diagnosis. Different phenotypes based on morphology and topographic location, ethnicity, and age are discussed. A better-defined phenotype identification for atopic dermatitis will facilitate earlier and correct diagnosis of this complex condition and inform selection of the most appropriate treatment choice in an era in which targeted therapies may generate more individualized patient care.
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Affiliation(s)
- Giampiero Girolomoni
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Piazzale A. Stefani 1, Verona, 37126, Italy
| | - Marjolein de Bruin-Weller
- National Expertise Center of Atopic Dermatitis, Department of Dermatology and Allergology, University Medical Center, Utrecht, Netherlands
| | - Valeria Aoki
- Department of Dermatology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Kenji Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Mette Deleuran
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Luis Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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13
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Jing M, Yu Q, Zhu B, Yuan F, Zhang J, Peng L, Lin W, Chen M. Topical 0.05% clobetasol cream in the treatment of chronic hand eczema: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24418. [PMID: 33725820 PMCID: PMC7969293 DOI: 10.1097/md.0000000000024418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 01/04/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Chronic hand eczema (CHE) is a recurrent, frequently disabling skin condition that requires daily skin care to prevent transepidermal water loss, posing a significant burden of society and economy. In recent years, topical 0.05% clobetasol cream is widely used for the treatment of CHE for its efficacy, tolerability and safety. Whereas, no systematic review and meta-analysis has been updated up to now. Therefore, this work aims to assess the effectiveness and safety of topical 0.05% clobetasol cream in patients with CHE. METHODS Study on topical 0.05% clobetasol cream for CHE will be searched from their inception to December, 2020 with the language restrictions of English and Chinese in 8 databases (PubMed, Cochrane Library, Embase, the web of science, VIP, CNKI, CBM, and WAN FANG). According to the heterogeneity test, a fixed or random-effect model will be used to synthesize data. The primary outcome is the proportion of patients achieving more than 75% reduction in signs and symptoms according to the Hand Eczema Severity Index (HECSI). The secondary outcomes include: scored for 4 different characteristics of the lesions (redness, scaling, lichenification, and pruritus), QoL questionnaire, adverse events, and recurrence events. STATA 13.0 and Review Manager software 5.3 will be used for analysis and synthesis. Two or more reviewers will independently conduct the selection of studies, data extraction, and data analysis. RESULTS The results of the study expect to provide a high-quality, evidence-based recommendation on topical 0.05% clobetasol cream in the treatment of CHE for clinicians. CONCLUSION The study will provide scientific and useful evidence for better use of topical 0.05% clobetasol cream in treating CHE. ETHICS AND DISSEMINATION This study is a protocol for an overview of SRs/MAs that did not involve individual data. Thus, ethical approval is not required. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/SPHVZ.
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14
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Quaade AS, Simonsen AB, Halling AS, Thyssen JP, Johansen JD. Prevalence, incidence, and severity of hand eczema in the general population - A systematic review and meta-analysis. Contact Dermatitis 2021; 84:361-374. [PMID: 33548072 DOI: 10.1111/cod.13804] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/27/2021] [Accepted: 01/30/2021] [Indexed: 12/14/2022]
Abstract
Accurate assessments of the burden of hand eczema (HE) in the general population are important for public awareness and intervention. The aim of this systematic review and meta-analysis was to provide updated estimates of prevalence and incidence, alongside additional epidemiological endpoints on HE in the general population. PubMed, Embase and Web of Science were searched for studies reporting the prevalence and/or incidence of HE in the general population. Proportion meta-analyses were performed to calculate pooled estimates of prevalence, incidence, severity, and the proportion of individuals with HE and a history of atopic dermatitis. Sixty-six studies were included in the quantitative analysis encompassing 568 100 individuals. The pooled estimates for lifetime, 1-year, and point prevalence were 14.5% (95% confidence interval [CI]: 12.6-16.5), 9.1% (95% CI: 8.4-9.8) and 4.0% (95% CI: 2.6-5.7), respectively. The pooled incidence rate of HE was 7.3 cases/1000 person-years (95% CI: 5.4-9.5). The occurrence of HE was 1.5-2 times higher in females than males. More than one third suffered from moderate/severe disease and around one third had a history of atopic dermatitis. HE was a recurrent, long-lasting disease with an average age at onset of the early- to mid-twenties. In conclusion; HE is a highly prevalent disease in the general population and carries a significant risk of long-term or chronic disease.
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Affiliation(s)
- Anna S Quaade
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Anne B Simonsen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Anne-Sofie Halling
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jacob P Thyssen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jeanne D Johansen
- National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
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15
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Silvestre Salvador JF, Heras Mendaza F, Hervella Garcés M, Palacios-Martínez D, Sánchez Camacho R, Senan Sanz R, Apellaniz González A, Giménez-Arnau AM. Guidelines for the Diagnosis, Treatment, and Prevention of Hand Eczema. ACTAS DERMO-SIFILIOGRAFICAS 2021; 111:26-40. [PMID: 32197684 DOI: 10.1016/j.ad.2019.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/11/2019] [Accepted: 04/21/2019] [Indexed: 12/28/2022] Open
Abstract
Hand eczema is a common condition associated with significantly impaired quality of life and high social and occupational costs. Managing hand eczema is particularly challenging for primary care and occupational health physicians as the condition has varying causes and both disease progression and response to treatment are difficult to predict. Early diagnosis and appropriate protective measures are essential to prevent progression to chronic eczema, which is much more difficult to treat. Appropriate referral to a specialist and opportune evaluation of the need for sick leave are crucial to the good management of these patients. These guidelines cover the diagnosis, prevention, and treatment of chronic hand eczema and highlight the role that primary care and occupational health physicians can play in the early management of this disease.
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Affiliation(s)
| | - F Heras Mendaza
- Servicio de Dermatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - M Hervella Garcés
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Pamplona, España
| | - D Palacios-Martínez
- Medicina de Atención Primaria, Centro de Salud Isabel II, Parla, Madrid, España
| | | | - R Senan Sanz
- Equipo de Atención Primaria el Clot, Instituto Catalán de la Salud, Barcelona, España
| | - A Apellaniz González
- Departamento de Estomatología, Facultad de Medicina y Enfermería, Euskal Herriko Unibertsitatea-Universidad del País Vasco, Leioa, Bizkaia, España
| | - A M Giménez-Arnau
- Departamento de Dermatología, Hospital del Mar, Universitat Autónoma de Barcelona, Barcelona, España
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16
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Ulrich NH, Thyssen JP, Mizutani H, Nixon RL. Hand Eczema: Causative Factors, Diagnosis, Personal and Societal Consequences. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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17
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Abstract
Background Assessment of chronic hand eczema (CHE) is complex and warrants standardization. Objective We sought to guide clinicians on the assessment of CHE. Methods An electronic questionnaire regarding the diagnosis and assessment of CHE was completed by councilors (n=45) of the International Eczema Council, an international group of clinicians and researchers with expertise in CHE. The survey consisted of 52 statements for consensus. Results Overall, nine statements (17.3%) had strong, twenty-three (44.2%) moderate, 12 (23.1%) low, and 8 (15.4%) very low levels of agreement. Five statements had considerable disagreement, including the value of conducting a skin biopsy (62.2% disagreement), investigating for possible type 1 reactions (60.0%), conducting a fungal culture (44.4%), finding no history of relevant allergens and/or irritants (31.1%) in most or all cases, and performing patch testing irrespective of lesion location and morphology (28.9%). Agreement was generally highest among respondents from Europe (28.6–77.8% agreement), followed by Asia (7.1%–35.7% agreement), North America (0%–35.5% agreement), and other (0%–13.3% agreement). Conclusions There were substantial differences of agreement, suggesting there are many knowledge and/or practice gaps with respect to CHE. Future research is needed to inform evidence-based and/or consensus guidelines for CHE.
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18
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Wang X, Ye L, Lai Q, Wen S, Long Z, Qiu X, Elias PM, Yang B, Man MQ. Altered Epidermal Permeability Barrier Function in the Uninvolved Skin Supports a Role of Epidermal Dysfunction in the Pathogenesis of Occupational Hand Eczema. Skin Pharmacol Physiol 2020; 33:94-101. [PMID: 32224613 DOI: 10.1159/000506425] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 02/07/2020] [Indexed: 11/19/2022]
Abstract
Although a compromised epidermal permeability barrier can contribute to the development of contact dermatitis, whether subjects with hand eczema display abnormalities in baseline epidermal permeability barrier function in their uninvolved skin remains unknown. The aim of the present study was to assess epidermal permeability barrier function in subjects with and without hand eczema in clothing manufacturers. Upon approval by the institutional review board, volunteers were recruited from clothing manufacturers in Guangzhou City, China. An 11-item questionnaire was used to collect general data from the volunteers. The diagnoses of self-proclaimed hand eczema were further confirmed by a dermatologist. Epidermal biophysical properties, including transepidermal water loss (TEWL) rates, stratum corneum hydration and skin surface pH were measured on the flexural surface of the left forearm in all volunteers. Epidermal biophysical properties were compared among cohorts of subjects with active hand eczema, a prior history of hand eczema and without any history of hand eczema. A total of 650 questionnaires were collected from 462 females and 188 males, with a mean age of 36.7 ± 0.46 years (range 16-69 years; 95% CI 35.8-37.59). Thirty-five subjects (5.4%) currently had hand eczema, while 28 subjects (4.3%) reported a prior history of hand eczema that was inactive currently. The prevalence of hand eczema did not differ significantly between genders. Neither a prior personal nor a family history of allergies was associated with the prevalence of hand eczema, but certain occupations and frequent contact with disinfectants were independently associated with the prevalence of hand eczema. In the overall cohort, males displayed higher TEWL rates and stratum corneum hydration levels than did females. Both skin surface pH and TEWL rates differed significantly among normal controls and subjects with active hand eczema or a prior history of hand eczema (p < 0.05). In conclusion, the uninvolved skin site of subjects with hand eczema exhibits abnormalities in epidermal perme-ability barrier, supporting a pathogenic role of epidermal dysfunction in hand eczema. Whether subjects with hand eczema in other occupations also display altered epidermal function on uninvolved skin remains to be explored.
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Affiliation(s)
- Xiaohua Wang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Li Ye
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Qingsong Lai
- Center of Chronic Disease Prevention, Puning City, China
| | - Si Wen
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Zijun Long
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Xiaoyu Qiu
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Peter M Elias
- Department of Dermatology, University of California San Francisco and Veterans Affairs Medical Center, San Francisco, California, USA
| | - Bin Yang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Mao-Qiang Man
- Dermatology Hospital, Southern Medical University, Guangzhou, China,
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19
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Ulrich NH, Thyssen JP, Mizutani H, Nixon RL. Hand Eczema: Causative Factors, Diagnosis, Personal and Societal Consequences. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_61-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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20
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21
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Worm M, Bauer A, Elsner P, Mahler V, Molin S, Nielsen T. Efficacy and safety of topical delgocitinib in patients with chronic hand eczema: data from a randomized, double‐blind, vehicle‐controlled phase
II
a study. Br J Dermatol 2019; 182:1103-1110. [DOI: 10.1111/bjd.18469] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2019] [Indexed: 12/31/2022]
Affiliation(s)
- M. Worm
- Division of Allergy and Immunology Department of Dermatology and Allergy Charité Universitätsmedizin Berlin Berlin Germany
| | - A. Bauer
- Department of Dermatology University Allergy Center University Hospital Carl Gustav Carus Technical University Dresden Germany
| | - P. Elsner
- Department of Dermatology University Hospital Jena Jena Germany
| | - V. Mahler
- Department of Dermatology University Hospital Erlangen Erlangen Germany
| | - S. Molin
- Division of Dermatology Queen's University Kingston ON Canada
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22
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Topal Y, Agner T, van der Heiden J, Ebbehøj NE, Clemmensen KKB. Hand eczema patients’ knowledge of skin protection following a guided talk—A retrospective study with a follow‐up questionnaire. Contact Dermatitis 2019; 81:117-123. [DOI: 10.1111/cod.13264] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 02/25/2019] [Accepted: 03/05/2019] [Indexed: 12/31/2022]
Affiliation(s)
- Yasemin Topal
- Department of DermatologyBispebjerg University Hospital Copenhagen Denmark
| | - Tove Agner
- Department of DermatologyBispebjerg University Hospital Copenhagen Denmark
| | | | - Niels E. Ebbehøj
- Department of Occupational and Environmental MedicineBispebjerg University Hospital Copenhagen Denmark
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23
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Ulrich NH, Thyssen JP, Mizutani H, Nixon RL. Hand Eczema. Contact Dermatitis 2019. [DOI: 10.1007/978-3-319-72451-5_61-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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24
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Cazzaniga S, Ballmer-Weber BK, Gräni N, Spring P, Bircher A, Anliker M, Sonntag AK, Piletta P, Huber C, Diepgen TL, Apfelbacher C, Naldi L, Borradori L, Simon D. Chronic hand eczema: A prospective analysis of the Swiss CARPE registry focusing on factors associated with clinical and quality of life improvement. Contact Dermatitis 2018; 79:136-148. [DOI: 10.1111/cod.13041] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/09/2018] [Accepted: 05/03/2018] [Indexed: 12/16/2022]
Affiliation(s)
- Simone Cazzaniga
- Department of Dermatology, Inselspital; Bern University Hospital; Bern Switzerland
- Centro Studio, Italian Group for Epidemiological Research in Dermatology (GISED); Bergamo Italy
- Graduate School for Cellular and Biomedical Sciences; University of Bern; Bern Switzerland
| | - Barbara K. Ballmer-Weber
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
- Faculty of Medicine; University of Zurich; Zurich Switzerland
- Allergy Unit, Clinic of Dermatology and Allergology; Cantonal Hospital St Gallen; St. Gallen Switzerland
| | - Nora Gräni
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
| | - Philippe Spring
- Department of Dermatology; University Hospital of Lausanne CHUV; Lausanne Switzerland
| | - Andreas Bircher
- Department of Dermatology; University Hospital Basel; Basel Switzerland
| | - Mark Anliker
- Clinic of Dermatology and Allergology; Cantonal Hospital St Gallen; St Gallen Switzerland
- Hautärzte am Graben; Winterthur Switzerland
| | | | - Pierre Piletta
- Department of Dermatology; Geneva University Hospitals (HUG); Geneva Switzerland
| | - Caroline Huber
- Department of Dermatology; Geneva University Hospitals (HUG); Geneva Switzerland
- Dermatology Office; Versoix Switzerland
| | - Thomas L. Diepgen
- Department of Clinical Social Medicine, Occupational and Environmental Dermatology; University Hospital, Ruprecht Karls University; Heidelberg Germany
| | - Christian Apfelbacher
- Institute of Epidemiology and Preventive Medicine; University of Regensburg; Regensburg Germany
| | - Luigi Naldi
- Centro Studio, Italian Group for Epidemiological Research in Dermatology (GISED); Bergamo Italy
- Department of Dermatology; San Bortolo Hospital; Vicenza Italy
| | - Luca Borradori
- Department of Dermatology, Inselspital; Bern University Hospital; Bern Switzerland
| | - Dagmar Simon
- Department of Dermatology, Inselspital; Bern University Hospital; Bern Switzerland
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Minami T, Fukutomi Y, Sekiya K, Akasawa A, Taniguchi M. Hand eczema as a risk factor for food allergy among occupational kitchen workers. Allergol Int 2018; 67:217-224. [PMID: 28874315 DOI: 10.1016/j.alit.2017.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 07/27/2017] [Accepted: 08/03/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND An increasing number of studies in children is highlighting the importance of transdermal routes of exposure to food allergens through damaged skin in the pathogenesis of food allergies. However, data on this in adults are limited. A few case-series studies has documented development of food allergy among kitchen workers with hand eczema after direct contact exposure to foods. METHODS To explore the significance of hand eczema as a risk factor for food allergies in adults at the epidemiological level, we performed a cross-sectional web-based questionnaire survey on kitchen workers whose exposures were classed as occupational (cooks and food handlers, n = 1592) or non-occupational (housewives, n = 1915). Logistic regression was used to explore the association between the presence/severity of hand eczema and the risk of food allergy after adjustment for potential confounders. RESULTS Current hand eczema and current diagnosed food allergy were more common among occupational kitchen workers (OKW) than among non-occupational kitchen workers (NOKW) (32.3%-vs-29.9% and 9.9%-vs-3.8%, respectively). Current hand eczema was significantly associated with increased risk of current diagnosed food allergy in OKW (adjusted odds ratio 2.4, 95% CI 1.6-3.7). Those with more severe hand eczema were more likely to suffer from allergic symptoms for foods, and diagnosed food allergy. CONCLUSIONS This study illustrates a significant public health problem in the adult population, documenting a major impact of hand eczema on the ongoing adult food allergy epidemic.
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Heede NG, Thuesen BH, Thyssen JP, Linneberg A, Szecsi PB, Stender S, Menné T, Johansen JD. Hand eczema, atopic dermatitis and filaggrin mutations in adult Danes: a registry-based study assessing risk of disability pension. Contact Dermatitis 2017; 77:95-105. [DOI: 10.1111/cod.12786] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 01/16/2017] [Accepted: 02/05/2017] [Indexed: 02/01/2023]
Affiliation(s)
- Nina G. Heede
- Department of Dermatology and Allergy, The National Allergy Research Centre; Copenhagen University Hospital Herlev-Gentofte; 2900 Hellerup Denmark
| | - Betina H. Thuesen
- Research Centre for Prevention and Health, the Capital Region of Denmark; 2600 Glostrup Denmark
| | - Jacob P. Thyssen
- Department of Dermatology and Allergy, The National Allergy Research Centre; Copenhagen University Hospital Herlev-Gentofte; 2900 Hellerup Denmark
| | - Allan Linneberg
- Research Centre for Prevention and Health, the Capital Region of Denmark; 2600 Glostrup Denmark
- Department of Clinical Experimental Research; Rigshospitalet; 2600 Glostrup Denmark
- Faculty of Health and Medical Sciences, Department of Clinical Medicine; University of Copenhagen; 2200 Copenhagen Denmark
| | - Pal B. Szecsi
- Department of Clinical Biochemistry; Copenhagen University Hospital Herlev-Gentofte; 2900 Hellerup Denmark
| | - Steen Stender
- Department of Clinical Biochemistry; Copenhagen University Hospital Herlev-Gentofte; 2900 Hellerup Denmark
| | - Torkil Menné
- Department of Dermatology and Allergy, The National Allergy Research Centre; Copenhagen University Hospital Herlev-Gentofte; 2900 Hellerup Denmark
| | - Jeanne D. Johansen
- Department of Dermatology and Allergy, The National Allergy Research Centre; Copenhagen University Hospital Herlev-Gentofte; 2900 Hellerup Denmark
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27
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Crane M, Webb D, Watson E, Cunliffe T, English J. Hand eczema and steroid-refractory chronic hand eczema in general practice: prevalence and initial treatment. Br J Dermatol 2017; 176:955-964. [DOI: 10.1111/bjd.14974] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2016] [Indexed: 11/30/2022]
Affiliation(s)
- M.M. Crane
- GlaxoSmithKline; Research Triangle Park NC U.S.A
- Consultant epidemiologist; Chapel Hill NC U.S.A
| | | | - E. Watson
- GlaxoSmithKline; Research Triangle Park NC U.S.A
- Consultant epidemiologist; Chapel Hill NC U.S.A
| | - T. Cunliffe
- South Tees Hospitals NHS Foundation Trust; Northallerton U.K
| | - J. English
- Nottingham University Hospitals NHS Trust; Nottingham U.K
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Kostner L, Anzengruber F, Guillod C, Recher M, Schmid-Grendelmeier P, Navarini AA. Allergic Contact Dermatitis. Immunol Allergy Clin North Am 2017; 37:141-152. [DOI: 10.1016/j.iac.2016.08.014] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Minamoto K, Watanabe T, Diepgen TL. Self-reported hand eczema among dental workers in Japan - a cross-sectional study. Contact Dermatitis 2016; 75:230-9. [PMID: 27523777 DOI: 10.1111/cod.12656] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 06/10/2016] [Accepted: 06/10/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dental workers are considered to have a high risk of developing occupational hand eczema. OBJECTIVES To estimate the prevalence of work-related hand eczema and associated risk factors in dental workers in Japan. METHODS A self-administered questionnaire was sent by mail to all dental clinics of Kumamoto City, Japan. In addition, patch testing with 24 dentistry-related allergens was offered. RESULTS In total, 46.4% of dental workers (n = 528: response 31.4%, based on 97 clinics) reported a lifetime history of chronic hand eczema. The 1-year prevalence was 36.2%. According to logistic regression analysis, the most important risk factors for the 1-year prevalence were a personal history of atopic dermatitis [odds ratio (OR) 4.7, 95% confidence interval (CI): 2.2-8.8], asthma and/or allergic rhinitis (OR 2.0, 95%CI: 1.3-3.0), dry skin (OR 1.7, 95%CI: 1.1-2.7), shorter duration of work (OR 2.0, 95%CI: 1.2-3.5 for up to 10 years versus >20 years), and washing hands >10 times per day (OR 1.6, 95%CI: 1.0-2.5). Fifty-four workers were patch tested. Rubber chemicals and acrylates were the most frequent occupationally relevant contact allergens. CONCLUSIONS Dental workers in Japan have a high prevalence of hand eczema. Health education to prevent hand eczema and more frequent patch testing are needed.
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Affiliation(s)
- Keiko Minamoto
- Department of Public Health, Faculty of Life Sciences, Graduate School of Kumamoto University, Kumamoto 860-8556, Japan. ,
| | | | - Thomas L Diepgen
- Department of Social Medicine, Occupational & Environmental Dermatology, University of Heidelberg, 69115 Heidelberg, Germany
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Heede N, Thyssen J, Thuesen B, Linneberg A, Johansen J. Predictive factors of self-reported hand eczema in adult Danes: a population-based cohort study with 5-year follow-up. Br J Dermatol 2016; 175:287-95. [DOI: 10.1111/bjd.14476] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2016] [Indexed: 01/10/2023]
Affiliation(s)
- N.G. Heede
- Department of Dermato-Allergology; The National Allergy Research Centre; Copenhagen University Hospital Herlev-Gentofte; Kildegårdsvej 28 2900 Hellerup Denmark
| | - J.P. Thyssen
- Department of Dermato-Allergology; The National Allergy Research Centre; Copenhagen University Hospital Herlev-Gentofte; Kildegårdsvej 28 2900 Hellerup Denmark
| | - B.H. Thuesen
- Research Centre for Prevention and Health; The Capital Region of Denmark; Copenhagen Denmark
| | - A. Linneberg
- Research Centre for Prevention and Health; The Capital Region of Denmark; Copenhagen Denmark
- Department of Clinical Experimental Research; Rigshospitalet; Glostrup Denmark
- Department of Clinical Medicine; Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | - J.D. Johansen
- Department of Dermato-Allergology; The National Allergy Research Centre; Copenhagen University Hospital Herlev-Gentofte; Kildegårdsvej 28 2900 Hellerup Denmark
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Apfelbacher C. Onset and severity of atopic dermatitis, atopy and hand eczema in adolescents. Br J Dermatol 2015; 173:1121-2. [DOI: 10.1111/bjd.14192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- C. Apfelbacher
- Institute of Epidemiology and Preventive Medicine; University of Regensburg; Dr.-Gessler-Str. 17 93051 Regensburg Germany
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Grönhagen C, Lidén C, Wahlgren CF, Ballardini N, Bergström A, Kull I, Meding B. Hand eczema and atopic dermatitis in adolescents: a prospective cohort study from the BAMSE project. Br J Dermatol 2015; 173:1175-82. [PMID: 26152456 DOI: 10.1111/bjd.14019] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is a well-known association between atopic dermatitis (AD) and hand eczema but less is known about how age at onset, persistence and severity of AD influence the risk of developing hand eczema. OBJECTIVES To examine the role of AD in the occurrence of hand eczema in adolescence. In addition, associations between asthma and rhinoconjunctivitis, sensitization to common airborne and food allergens, and hand eczema were studied. METHODS From the population-based birth cohort BAMSE, 2927 adolescents who had been followed up repeatedly concerning allergy-related disease were included. Questionnaires identified adolescents with hand eczema at 16 years, and their blood was analysed for specific IgE. RESULTS A total of 152 (5·2%) adolescents had hand eczema at the age of 16 years. Many of these adolescents had a history of AD (n = 111; 73·0%) and asthma and/or rhinitis (n = 83; 54·6%), respectively. Children with AD (aged 0-16 years) had more than threefold increased odds ratios (OR) for having hand eczema; those with persistent or severe AD had a crude OR of 6·1 [95% confidence interval (CI) 4·0-9·1] and 5·3 (95% CI 2·9-9·6), respectively. CONCLUSIONS We confirm a strong association between AD during childhood and hand eczema in adolescence. Children with persistent or more severe AD are at greater risk of developing hand eczema. Asthma and/or rhinoconjunctivitis, positive specific IgE or age at onset of AD are not associated with hand eczema in adolescence.
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Affiliation(s)
- C Grönhagen
- Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden
| | - C Lidén
- Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden
| | - C-F Wahlgren
- Karolinska Institutet and Karolinska University Hospital, Dermatology Unit, Department of Medicine, Stockholm, Sweden
| | - N Ballardini
- Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden.,South General Hospital, Sachs' Children and Youth Hospital, Stockholm, Sweden
| | - A Bergström
- Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden
| | - I Kull
- Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden.,South General Hospital, Sachs' Children and Youth Hospital, Stockholm, Sweden.,South General Hospital, Department of Clinical Science and Education, Stockholm, Sweden
| | - B Meding
- Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden
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Do young adults with atopic dermatitis avoid harmful workplace exposure at their first job? A prospective cohort study. Int Arch Occup Environ Health 2015; 89:397-406. [PMID: 26188734 DOI: 10.1007/s00420-015-1078-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 07/07/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Patients with atopic dermatitis (AD) are at high risk of chronic hand eczema. In this prospective cohort study, we assessed the influence of pre-hire-onset AD on the first job choice. We also analysed the potential association between AD and usage of preventive measures in high-risk occupations. METHODS Subjects (aged 19-24 years) who were followed from childhood until the second Study on Occupational Allergy Risks and indicated a job were included (n = 1566). We defined AD as doctor-diagnosed AD and symptoms of an itchy rash during the past 12 months before the study. Pre-hire-onset AD was having AD prior to the first job. Preventive measure usage was self-reported gloves use or use of ointment or moisturizer. We performed multiple imputations to deal with missing values and analysed associations using logistic regression models adjusted for several potential confounders. RESULTS Risk categories of the first job did not differ between participants with pre-hire-onset AD and those without (odds ratio 1.05, 95 % confidence interval 0.59-1.87). AD status was not statistically significantly associated with usage of preventive measures (1.22, 0.56-2.64). Conversely, having received job counselling (2.76, 1.15-6.63) and a family history of AD (2.09, 1.01-4.31) were associated with a higher use of such measures. CONCLUSION We could not confirm a healthy hire effect in this cohort of young adults. Although subjects with AD in high-risk occupations do not seem to use more preventive measures than their non-affected peers, job counselling seems to be an effective approach to encourage secondary prevention.
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Heede NG, Thyssen JP, Thuesen BH, Linneberg A, Johansen JD. Anatomical patterns of dermatitis in adult filaggrin mutation carriers. J Am Acad Dermatol 2015; 72:440-8. [DOI: 10.1016/j.jaad.2015.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 12/12/2014] [Accepted: 01/05/2015] [Indexed: 01/28/2023]
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Petersen A, Johansen J, Hald M. Hand eczema - prognosis and consequences: a 7-year follow-up study. Br J Dermatol 2014; 171:1428-33. [DOI: 10.1111/bjd.13371] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2014] [Indexed: 11/29/2022]
Affiliation(s)
- A.H. Petersen
- National Allergy Research Centre; Copenhagen University Hospital Gentofte; Kildegaardsvej 28 DK-2900 Hellerup Denmark
| | - J.D. Johansen
- National Allergy Research Centre; Copenhagen University Hospital Gentofte; Kildegaardsvej 28 DK-2900 Hellerup Denmark
| | - M. Hald
- Department of Dermato-Allergology; Copenhagen University Hospital Gentofte; Kildegaardsvej 28 DK-2900 Hellerup Denmark
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